Evidence map›Paper›PMID 40237906›Full record

ArticleDigestive diseases and sciences2025

Comparative Effectiveness of Bile Acid Sequestrants and Antibiotics in the Management of Acute Pouchitis: A Matched Cohort Study from the United States.

Saqr Alsakarneh, Michael Camilleri, Francis A Farraye, Jana G Hashash

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Abnormal MUC1 Expression as a Biomarker for Pouchitis.Digestive diseases and sciences · 2026
    Article
  4. Increased risk ofAnnals of gastroenterology
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Saqr AlsakarnehDepartment of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA. s.alsakarneh@umkc.edu.
Michael CamilleriDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Francis A FarrayeDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.
Jana G HashashDivision of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsBile acid sequestrants (BAS) are an emerging option for treatment of pouchitis. We aimed to compare BAS monotherapy, antibiotics, and combination therapy with both in the treatment of pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC).

methodsWe conducted a retrospective cohort study using the US-Collaborative TriNetX database to identify patients with acute pouchitis and UC. Treatment groups were divided into BAS (cholestyramine, colesevelam, colestipol), antibiotics (ciprofloxacin and/or metronidazole), and combination therapy of both BAS and antibiotics. Primary outcomes were failure of initial therapy (early relapse or nonresponse) and the development of recurrent pouchitis in the first 12 months after an initial episode of pouchitis.

resultsOur analysis included 1,136 patients (mean age: 37.8 ± 15.4 years, and 45.9% female) of whom 727 (64%) were diagnosed with recurrent pouchitis. After adjusting for confounders by propensity-score matching, there was no significant difference in the odds of early relapse or nonresponse with BAS compared with antibiotic monotherapy (aOR: 0.74; 95% CI: 0.40-1.38; p = 0.34) or combination therapy (aOR: 0.94; 95% CI: 0.47-1.88; p = 0.86). Patients treated with BAS had a statistically significant lower recurrent pouchitis rate (aHR: 0.57; 95% CI: 0.42-0.79; p < 0.001) compared with patients treated with antibiotics. Patients treated with BAS had a statistically significant longer time (median: 225 days) to recurrent pouchitis (p < 0.001) compared to antibiotics (median: 99 days).

conclusionUsing real-world evidence regarding treatment of pouchitis compared to standard antibiotic therapy, BAS monotherapy was not inferior for initial treatment response and significantly prolonged time to recurrent pouchitis.

Indexed as

Anti-Bacterial AgentsBile Acids and SaltsColitis, UlcerativePouchitisAcute DiseaseAdultCholestyramine ResinCiprofloxacinColesevelam HydrochlorideDrug Therapy, CombinationFemaleHumansMaleMetronidazoleMiddle AgedProctocolectomy, RestorativeAnti-Bacterial AgentsBile Acids and SaltsCholestyramine ResinCiprofloxacinColesevelam HydrochlorideMetronidazoleIPAAPropensity-score matchingUlcerative colitis

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.